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Pape LM, van Straten A, Struijs SY, Spinhoven P, Antypa N. Effectiveness of a guided digital self-help intervention to improve sleep and the biological clock in university students - Study protocol for a randomized controlled trial. Internet Interv 2024; 37:100763. [PMID: 39224668 PMCID: PMC11367106 DOI: 10.1016/j.invent.2024.100763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/22/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Background Sleep problems occur in many university students which affects their mental health and daily functioning. Cognitive behavioural therapy for insomnia (CBT-I) has been proven effective in adults but research in university students, who struggle to maintain a 24-hour rhythm, is still limited. We hypothesize that a guided digital CBT-I intervention, enriched with components on the biological clock ('i-Sleep & BioClock') will be effective in reducing insomnia severity and improving mental health outcomes for students with sleep problems. Objectives We aim to evaluate the effectiveness of a guided online sleep and biological clock self-help intervention in improving sleep, depression symptoms, anxiety symptoms, functioning, academic performance, and quality of life in university students at 6 weeks and 18 weeks. Methods This is a two-arm parallel-group superiority randomized controlled trial, comparing a 5-week guided online 'i-Sleep & BioClock' intervention to online psychoeducation (PE). We aim to include 192 university students (Bachelor, Master, and PhD) with at least subthreshold insomnia (Insomnia Severity Index ≥10), aged ≥16, who can speak Dutch or English. We are excluding students with current risk for suicide or night shifts. The primary outcome is insomnia severity. Secondary outcomes include sleep estimates (sleep and light exposure diary), depression, anxiety, functioning, quality of life, and academic performance. The effectiveness of the intervention compared to online PE will be evaluated using linear mixed models. Discussion The current study tests the effectiveness of an online self-help intervention for university students who suffer from sleep problems. This trial builds upon an open feasibility study and will provide evidence of an online guided self-help program for students. The findings of this study will determine the potential wider dissemination of the intervention to address the high need for available and accessible help for students experiencing insomnia. Trial registration ClinicalTrials.Gov (NCT06023693), registered on August 3rd, 2023.
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Affiliation(s)
- Laura M. Pape
- Department of Clinical Psychology, Leiden University, the Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Sascha Y. Struijs
- Department of Clinical, Neuro- and Developmental Psychology, VU University Amsterdam, the Netherlands
| | - Philip Spinhoven
- Department of Clinical Psychology, Leiden University, the Netherlands
| | - Niki Antypa
- Department of Clinical Psychology, Leiden University, the Netherlands
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Lu M, Liu M, Zhan K, Chen Y, Liu X. Dynamic analysis of the relationship between systemic lupus erythematosus disease activity and psychosocial support. Front Psychol 2024; 15:1433868. [PMID: 39205979 PMCID: PMC11350976 DOI: 10.3389/fpsyg.2024.1433868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Background Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease that significantly affects both the physical and mental health of patients. Psychosocial support systems play a crucial role in managing chronic diseases, yet their specific impact on the disease activity of SLE patients remains unclear. This study aims to explore the dynamic relationship between disease activity in SLE patients and various types of psychosocial support systems. Methods We conducted a retrospective longitudinal observational study, including 150 SLE patients who received treatment at our hospital from January 2022 to January 2023. Emotional support, tangible support, social interaction support, and informational support were assessed using the revised Social Support Rating Scale. Disease activity was quantified using the European Consensus Lupus Activity Measurement. The relationship between psychosocial support and disease activity was analyzed using Spearman's rank correlation coefficient and multiple linear regression models, with Bootstrap resampling employed to test the robustness of the results. Results We found a significant negative correlation between psychosocial support and SLE disease activity, with emotional support, social interaction support, and informational support showing stronger negative correlations. Multiple regression analysis revealed that the inhibitory effects of emotional support, social interaction support, and informational support on disease activity increased over time. Although the impact of tangible support was not statistically significant, it gradually became more apparent over time. Conclusion Our findings indicate a significant negative correlation between psychosocial support and SLE disease activity, particularly with emotional support, social interaction support, and informational support. Over time, the impact of tangible support also becomes evident. These findings provide important references for the comprehensive treatment and management of SLE patients. However, due to the observational nature of the study, the causality of this relationship requires further exploration.
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Affiliation(s)
- Miao Lu
- Second Clinical College, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Min Liu
- Department of Traditional Chinese Medicine, Hangzhou Red Cross Hospital, Zhejiang Province, Hangzhou, Zhejiang, China
| | - Kuijun Zhan
- Second Clinical College, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Yutong Chen
- Second Clinical College, Zhejiang Chinese Medicine University, Hangzhou, Zhejiang, China
| | - Xide Liu
- Department of Traditional Chinese Medicine, Hangzhou Red Cross Hospital, Zhejiang Province, Hangzhou, Zhejiang, China
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Tang Y, Abildso CG, Lilly CL, Winstanley EL, Rudisill TM. Risk factors associated with driving after marijuana use among West Virginia college students during the COVID-19 pandemic. TRAFFIC INJURY PREVENTION 2024; 25:579-588. [PMID: 38572915 DOI: 10.1080/15389588.2024.2333906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES The purpose of this study was to assess sociodemographic and behavioral risk factors associated with driving after marijuana use (DAMU) among West Virginia college students. METHODS Participants were recruited from West Virginia University between September and November 2022. The study sample was restricted to students who were ≥18 years of age; reported recently driving; possessed a current, valid driver's license from any US state; and were enrolled for at least one credit hour in the Fall 2022 semester. RESULTS Among respondents (N = 772), 28.9% reported DAMU. Students who had a GPA of B (adjusted odds ratio [AOR]: 2.17, 95% confidence interval [CI]: 1.06-4.42), smoked or ingested marijuana in the past year (AOR: 26.51, 95% CI: 10.27-68.39), drove after drinking (AOR: 2.38, 95% CI: 1.18-4.79), and used both marijuana and alcohol concurrently and then drove (AOR: 10.39, 95% CI: 2.32-46.54) associated with DAMU. Individuals who felt the behavior was somewhat dangerous or not dangerous or thought their peers approved of DAMU showed significant associations with DAMU. CONCLUSIONS As DAMU was prevalent, future interventions that raise awareness of the danger and potential consequences of DAMU may be needed to reduce this risky behavior on college campuses.
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Affiliation(s)
- Yuni Tang
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Christa L Lilly
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia
| | - Erin L Winstanley
- General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Toni M Rudisill
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia
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Niculescu I, Rappaport LM, Romero K. Rumination, but not mood, predicts prospective memory performance: novel insights from a derived measure of trait rumination. Cogn Emot 2024:1-11. [PMID: 38564188 DOI: 10.1080/02699931.2024.2337138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
Prospective memory (PM) is the accurate execution of an intention in the future. PM may be negatively impacted by negative affect, but the underlying mechanisms remain unclear. Rumination may increase the frequency of task-irrelevant thoughts, which deplete attentional capacity and reduce performance. To date, no studies have examined state and trait rumination on an online measure of PM. The present study examined the effects of state and trait rumination on an event-based, focal PM task embedded within a one-back task over multiple sessions. 95 non-depressed adults (18-53 years) completed measures of state/trait rumination, mood, and PM on at least two occasions. Using multi-level modelling, we found that a derived measure of trait rumination, but not an established trait rumination survey, nor negative mood, predicted poorer PM accuracy. These novel findings demonstrate that trait rumination may partially underlie the association between negative affect & PM in a non-clinical sample, and highlight the potential of online methods to study PM.
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Affiliation(s)
- Iulia Niculescu
- Department of Psychology, University of Windsor, Windsor, Canada
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Villarreal-Zegarra D, Paredes-Angeles R, Mayo-Puchoc N, Arenas-Minaya E, Huarcaya-Victoria J, Copez-Lonzoy A. Psychometric properties of the GAD-7 (General Anxiety Disorder-7): a cross-sectional study of the Peruvian general population. BMC Psychol 2024; 12:183. [PMID: 38566138 PMCID: PMC10985987 DOI: 10.1186/s40359-024-01688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Anxiety disorders are among the main mental health problems worldwide and are considered one of the most disabling conditions. Therefore, it is essential to have measurement tools that can be used to screen for anxiety symptoms in the general population and thus identify potential cases of people with anxiety symptoms and provide them with timely care. Our aim was to evaluate the psychometric properties of the General Anxiety Disorder-7 scale (GAD-7) in the Peruvian population. METHOD Our study was a cross-sectional study. The sample included people aged 12 to 65 years in Peru. Confirmatory factor analysis, analysis of measurement invariance, convergent validity with the Patient Health Questionnaire-9 (PHQ-9) and internal consistency analysis were performed. RESULTS In total, 4431 participants were included. The one-factor model showed the best fit (CFI = 0.994; TLI = 0.991; RMSEA = 0.068; WRMR = 1.567). The GAD-7 score showed measurement invariance between men and women and between age groups (adults vs. adolescents) (ΔCFI < 0.01). The internal consistency of the one-factor model was satisfactory (ω = 0.90, α = 0.93). The relationship between depressive symptoms (PHQ-9) and anxiety symptoms (GAD-7) presented a moderate correlation (r = 0.77). CONCLUSIONS Our study concluded that the GAD-7 score shows evidence of validity and reliability for the one-factor model. Furthermore, because the GAD-7 score is invariant, comparisons can be made between groups (i.e., by sex and age group). Finally, we recommend the use of the GAD-7 for the general population in the Peruvian context.
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Affiliation(s)
- David Villarreal-Zegarra
- Universidad César Vallejo, Escuela de Medicina, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Filial Ica, Ica, Peru
| | - Anthony Copez-Lonzoy
- Universidad San Ignacio de Loyola, Lima, Peru.
- Instituto Peruano de Orientación Psicológica, Lima, Peru.
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Ahuvia IL, Sung JY, Dobias ML, Nelson BD, Richmond LL, London B, Schleider JL. College student interest in teletherapy and self-guided mental health supports during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:940-946. [PMID: 35427460 DOI: 10.1080/07448481.2022.2062245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/24/2022] [Accepted: 03/30/2022] [Indexed: 06/14/2023]
Abstract
Objective The COVID-19 pandemic has worsened college students' mental health while simultaneously creating new barriers to traditional in-person care. Teletherapy and online self-guided mental health supports are two potential avenues for addressing unmet mental health needs when face-to-face services are less accessible, but little is known about factors that shape interest in these supports. Participants: 1,224 U.S. undergraduate students (mean age = 20.7; 73% female; 40% White) participated. Methods: Students completed an online questionnaire assessing interest in teletherapy and self-guided supports. Predictors included age, sex, race/ethnicity, sexual minority status, and anxiety and depression symptomatology. Results: Interest rates were 20% and 25% for at-cost supports (teletherapy and online self-help, respectively) and 70% and 72% for free supports (teletherapy and online self-help, respectively). Patterns emerged by age, anxiety symptom severity, and race/ethnicity. Conclusions: Results may inform universities' efforts to optimize students' engagement with nontraditional, digital mental health supports, including teletherapy and self-guided programs. The SARS-CoV2 (COVID-19) pandemic has taken a severe toll on public health, with effects reaching far beyond unprecedented illness and mortality. Levels of mental health difficulties appear to be rising broadly as the pandemic has progressed, both in the general U.S. population and among college students specifically.1,2 The COVID-19 pandemic and its repercussions may undermine college student mental health in myriad ways.2 Concurrently, students now face the potential for serious illness, loss of loved ones, financial strain, social isolation, loss of on-campus resources, and sudden disruption of routines-creating a "perfect storm" for the emergence or exacerbation of psychological distress.
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Affiliation(s)
- Isaac L Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jenna Y Sung
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Bonita London
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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Robeson M, Brasil KM, Adams HC, Zlomke KR. Measuring depression and anxiety in autistic college students: A psychometric evaluation of the PHQ-9 and GAD-7. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241240183. [PMID: 38514920 DOI: 10.1177/13623613241240183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
LAY ABSTRACT Anxiety, depression, and suicidality are major concerns among college students, though less is known about these constructs in autistic college students. Given the rising number of autistic individuals entering college, adequate screening and diagnosis of mental health difficulties is necessary to provide care to this population. For example, despite widespread usage of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), it is unknown if the two instruments accurately measure depression and anxiety the same way between non-autistic and autistic individuals. Thus, the current study was the first to examine how these instruments measure depression and anxiety symptoms in autistic versus non-autistic college students. Utilizing tests of construct measurement in a sample of autistic (n = 477) and non-autistic (n = 429) university students aged 18-29, results showed that while the GAD-7 and PHQ-9 appear to be accurately capturing anxiety and depression in autistic college students, the PHQ-9 item assessing suicidality was found to be measuring different things. This indicates that autistic college students are not interpreting this question the way non-autistic students are, and thus, the measure is failing to capture suicidality in autistic people. Future investigators should continue to assess the appropriateness of using common screening measures, originally created by non-autistic people, in autistic populations.
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Wang F, Wu Y, Wang S, Du Z, Wu Y. Development of an optimal short form of the GAD-7 scale with cross-cultural generalizability based on Riskslim. Gen Hosp Psychiatry 2024; 87:33-40. [PMID: 38301522 DOI: 10.1016/j.genhosppsych.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
Despite the relatively small number of items in the GAD-7, fewer items are increasingly sought to shorten testing time in large-scale mental health screenings. As a result, short forms based on the GAD-7, the GAD-2, and GAD-mini, have become popular. However, the GAD-2 and GAD-mini have reported lower diagnostic accuracy in some cultural contexts, implying that a validated short-form version of the GAD-7 may be lacking in large-scale cross-cultural anxiety screening. Based on this, to develop an optimal short form of the GAD-7 with cross-cultural stability, we utilized seven GAD-7 datasets from six different countries, totaling 47,484 participants. Five 2 to 6 item short forms of the GAD were constructed using the Riskslim machine learning algorithm. We evaluated the diagnostic accuracy of the GAD-7 short forms in the training and test sets based on the coefficient of determination(R2) and area under the curve(AUC) metrics, and the results showed that GAD-R2 performed poorly in some cultures, and all of the 3 to 6 item short forms of the GAD performed good in cross-cultural diagnostic rates, with the GAD-R6 showing the highest diagnostic accuracy in all cultures; GAD-R3 outperformed GAD-R2, GAD-2, and GAD-mini in all cultures; GAD-R3 had higher generalizability across cultures and special populations; Given that the GAD-R3 was shorter and nearly as accurate as the GAD-R6, we recommend the use of the GAD-R3 in clinical studies and epidemiologic investigations. And we recommend the optimal actual cutoff value of 15 for GAD-R3. Overall, we recommend GAD-R3 as the short-form version of GAD-7 in cross-cultural studies. However, the 2-item GAD scale is also optimal for the short-form version in clinical practice.
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Affiliation(s)
- Fei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yunchou Wu
- School of Psychology, Southwest University,Chongqing, China
| | - Suqi Wang
- School of Philosophy, Anhui University, Hefei, China
| | - Zhuoran Du
- School of Philosophy, Anhui University, Hefei, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China.
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Bouloukaki I, Christodoulakis A, Margetaki K, Aravantinou Karlatou A, Tsiligianni I. Exploring the Link between Social Support and Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease Patients: A Cross-Sectional Study in Primary Care. Healthcare (Basel) 2024; 12:544. [PMID: 38470655 PMCID: PMC10930953 DOI: 10.3390/healthcare12050544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
We aimed to explore the link between social support and various patient-reported outcome measures (PROMs) in primary care patients with COPD. This was a cross-sectional study with 168 patients with COPD from six primary care centers in Crete, Greece. We collected data on sociodemographic characteristics, medical history, disease-specific quality of life, the COPD Assessment Test (CAT), fatigue, the Fatigue Severity Scale (FSS), phycological parameters, Patient Health Questionnaire-9, General Anxiety Disorder-7, sleep complaints, the Pittsburg Sleep Quality Index, the Athens Insomnia scale (AIS), and the Epworth Sleepiness Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Out of 168 patients with COPD, 114 (68.9%) exhibited low levels of social support. Low social support (MSPSS total ≤ 5) was positively associated with COPD symptoms (CAT score ≥ 10) (OR = 3.97, 95%CI:1.86-8.44; p < 0.01), fatigue (FSS ≥ 36) (OR = 2.74, 95%CI:1.31-5.74; p = 0.01), and insomnia symptoms (AIS ≥ 6) (OR = 5.17 95%CI:2.23-12.01; p < 0.01), while the association with depressive symptoms (PHQ-9 ≥ 10) was marginally significant (OR = 3.1, 95%CI:0.93-10.36; p = 0.07). Our results suggest that lower levels of social support are positively associated with PROMs in patients with COPD. Therefore, our findings show an additional way to improve the overall health of patients with COPD in primary care by putting social support at the epicenter of actions.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonia Aravantinou Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
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Feng LS, Li QL, Yang Q, Zhu YL, Yin FL, Wang QY, Zhong WJ, Wu XQ, Yan RY, Dong ZJ. Cognition of the warning symptoms and risk factors for cancer among Chinese college students: a cross-sectional study based on a summer social practice activity. Ann Med 2024; 55:2299574. [PMID: 38170847 PMCID: PMC10769110 DOI: 10.1080/07853890.2023.2299574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND To investigate the cognition of cancer warning symptoms and cancer risk factors among Chinese college students, analyze the influencing factors, and explain the correlations between cancer cognition and cancer symptom discrimination, cancer fear and psychological distress. METHODS Chinese college students were recruited in this cross-sectional study funded by a summer social practice activity in Yunnan Province, China. Cognition rates of cancer warning symptoms and cancer risk factors were evaluated using Cancer Warning symptoms Cognition Questionnaire (CWSCQ) and Cancer Risk Factors Cognition Questionnaire (CRFCQ), respectively. Factors associated with cognition of cancer warning symptoms, and factors associated with cognition of cancer risk factors were evaluated using multiple linear regression analysis. Interactions between cancer cognition, cancer symptom discrimination, psychological distress, and cancer fear were evaluated by structural equation modeling. RESULTS There were 846 effective samples, with an effective rate of 80.9%. The cognition rates of cancer warning symptoms were from 47.9% to 84.4%, which were affected by cancer symptom discrimination, education, attitudes towards cancer screening, living expenses, drinking history, and ways to obtain cancer knowledge (p < 0.05). The cognition rates of cancer risk factors were from 46.3% to 91.3% in participants, which were affected by education, cancer symptom discrimination, psychological distress, attitudes towards cancer screening, life satisfaction, cancer history in relatives and friends, ways to obtain cancer knowledge, smoking history, and nursing history for cancer patients (p < 0.05). Cancer cognition and cancer symptom discrimination showed intermediary effects on psychological distress and cancer fear (p < 0.001). CONCLUSIONS The overall cancer cognition situation among Chinese college students is not optimistic, which highlights the necessity of improving the cancer health literacy among Chinese college students. With the increasing morbidity and mortality rates of cancer, it is necessary to raise awareness of early detection, and early treatment of cancer among the general public. Health education interventions are helpful to improve cancer health literacy.
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Affiliation(s)
- Lin-sen Feng
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Qing-li Li
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Qing Yang
- School of Public Health, Kunming Medical University, Yunnan, China
| | - Yu-lu Zhu
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Fu-lin Yin
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Qi-yao Wang
- The First School of Clinical Medicine, Kunming Medical University, Yunnan, China
| | - Wen-jue Zhong
- Graduate School, Chulalongkorn University, Bangkok, Thailand
| | - Xiao-qian Wu
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Ruo-yu Yan
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
| | - Zheng-jiao Dong
- The Sixth Affiliated Hospital of Kunming Medical University (The People’s Hospital of Yuxi City), Yunnan, China
- School of General Practitioners, Kunming Medical University, Yunnan, China
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Kilkelly TJ, Palmer J, Kreashko L. Improving Mental Health Outcomes in Adolescent Patients With Universal Anxiety Screening in an Outpatient Pediatric Primary Care Office: A Quality Improvement Project. J Pediatr Health Care 2023; 37:688-695. [PMID: 37715758 DOI: 10.1016/j.pedhc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION In the wake of the cultural and mental health consequences that arose since the COVID-19 pandemic, primary care providers must be able to assess and initiate treatment of anxiety disorders in the pediatric population. Only 59% of children with a diagnosable anxiety disorder are identified and receive treatment. This quality improvement project aimed to evaluate the implementation of universal anxiety screening using the General Anxiety Disorder-7 tool in pediatric primary care. METHODS Screening was performed on adolescents (aged 12-18 years) to evaluate the frequency and acceptability of tool administration and identification of anxiety and referrals to mental health care for treatment. Employing a pretest-posttest design, the effect of universal anxiety screening for adolescents was measured at well-child visits. RESULTS Anxiety screening and anxiety diagnosis rates were significantly increased post-implementation. DISCUSSION Universal screening for anxiety was efficacious in the project setting for identifying cases of anxiety.
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Kalkbrenner MT, Gainza Perez MA, Hubbard JS. Measurement Invariance of Scores on the Somatic Symptom Scale-8: National Sample of Non-Clinical Adults in the United States. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2023; 57:263-275. [PMID: 38912298 PMCID: PMC11189620 DOI: 10.1080/07481756.2023.2243269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Objective The aim of the present study was to test the factorial invariance and convergent validity evidence of scores on the Somatic Symptom Scale (SSS)-8 with a national sample of adults living in the United States. Method A data collection contracting service was hired to recruit a national, non-clinical sample (N = 821) of adults in the United States stratified by the census data for age, gender, ethnicity, and geographic location. Results Factorial invariance testing via multiple-group confirmatory factor analysis revealed strong factorial invariance evidence (configural, metric, and scalar) of SSS-8 scores across gender, ethnicity, help-seeking history, education, and income. Convergent validity testing displayed strong correlations between SSS-8 scores and the following established measures: Patient Health Questinaire-9, Generalized Anxiety Disorder-7, and Mental Health Inventory-5. Conclusion Collectively, the results suggest that professional counselors can use the SSS-8 to enhance somatic symptomology screening efforts with adults living in the United States.
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Affiliation(s)
| | | | - JoAnna S Hubbard
- Department of Counseling and Educational Psychology, New Mexico State University
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13
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Ahuvia IL, Dobias ML, Cohen KA, Nelson BD, Richmond LL, London B, Schleider JL. Loss of mental health support among college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-7. [PMID: 37607035 DOI: 10.1080/07448481.2023.2245917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/15/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023]
Abstract
Objective: The COVID-19 pandemic has simultaneously exacerbated mental health concerns among college students and made it more challenging for many students to access mental health support. However, little is known about the extent of mental health support loss among college students, or which students have lost support. Participants: 415 undergraduate students who reported receiving mental health support prior to the pandemic participated. Methods: Students completed an online questionnaire between March and May of 2020. Researchers examined the extent of support loss and how support loss differed by demographic and mental health variables. Methods pre-registered at https://osf.io/m83hz. Results: 62% of respondents reported loss of mental health support. Loss of support was associated with more severe depressive symptoms (p < .001), more severe anxiety symptoms (p < .001), suicidal ideation (p < .001), and sexual minority identity (p = .017). Conclusions: Loss of support was common, especially among more vulnerable students.
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Affiliation(s)
- Isaac L Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Katherine A Cohen
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Brady D Nelson
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Bonita London
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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Virk P, Arora R, Burt H, Finnamore C, Gadermann A, Barbic S, Doan Q. Evaluating the Psychometric Properties and Clinical Utility of a Digital Psychosocial Self-Screening Tool (HEARTSMAP-U) for Postsecondary Students: Prospective Cohort Study. JMIR Ment Health 2023; 10:e48709. [PMID: 37556180 PMCID: PMC10448294 DOI: 10.2196/48709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Existing screening tools for mental health issues among postsecondary students have several challenges, including a lack of standardization and codevelopment by students. HEARTSMAP-U was adapted to address these issues. OBJECTIVE This study aimed to evaluate the suitability of HEARTSMAP-U as a self-screening tool for psychosocial issues among postsecondary students by evaluating its validity evidence and clinical utility. METHODS A prospective cohort study was conducted with University of British Columbia Vancouver students to evaluate HEARTSMAP-U's predictive validity and convergent validity. Participating students completed baseline and 3-month follow-up assessments via HEARTSMAP-U and a clinician-administered interview. RESULTS In a diverse student sample (n=100), HEARTSMAP-U demonstrated high sensitivity (95%-100%) in identifying any psychiatric concerns that were flagged by a research clinician, with lower specificity (21%-25%). Strong convergent validity (r=0.54-0.68) was demonstrated when relevant domains and sections of HEARTSMAP-U were compared with those of other conceptually similar instruments. CONCLUSIONS This preliminary evaluation suggests that HEARTSMAP-U may be suitable for screening in the postsecondary educational setting. However, a larger-scale evaluation is necessary to confirm and expand on these findings.
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Affiliation(s)
- Punit Virk
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ravia Arora
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Heather Burt
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | - Anne Gadermann
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada
| | - Skye Barbic
- Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Quynh Doan
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Paediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Bolgeo T, Di Matteo R, Simonelli N, Molin AD, Lusignani M, Bassola B, Vellone E, Maconi A, Iovino P. Psychometric properties and measurement invariance of the 7-item General Anxiety Disorder scale (GAD-7) in an Italian coronary heart disease population. J Affect Disord 2023; 334:213-219. [PMID: 37149049 DOI: 10.1016/j.jad.2023.04.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/21/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Generalized Anxiety Disorder is predominant in coronary heart disease (CHD) patients. 7-item Generalized Anxiety Disorder (GAD-7) scale psychometric properties have never been tested in CHD populations. This study aims to verify the GAD-7 psychometric properties and measurement invariance in an Italian CHD sample. METHOD A baseline data secondary analysis from HEARTS-IN-DYADS study. Several healthcare facilities enrolled an adult inpatient sample. Anxiety and depression data were collected using GAD-7 and Patient Health Questionnaire 9 (PHQ-9). Factorial validity was assessed with confirmatory factor analysis; construct validity was tested by correlating GAD-7 scores with PHQ-9 scores and other sociodemographic characteristics; internal consistency reliability was assessed using Cronbach's alpha and the composite reliability index, while confirmatory multigroup factor analysis was employed to investigate measurement invariance across gender and age (65 vs. 65). RESULTS We enrolled 398 patients (mean age 64.7 years; 78.9 % male; 66.8 % married). Factor structure was confirmed as unidimensional. Construct validity was confirmed with significant associations between GAD-7 and PHQ-9 scores, female gender, having a caregiver, and being employed. Cronbach's alpha and composite reliability index were 0.89 and 0.90, respectively. Measurement invariance across gender and age was confirmed at the scalar level. LIMITATIONS A convenience sample in one European country, a small female sample, validity testing against a single criterion. CONCLUSION Study results demonstrate adequate validity and reliability of the GAD-7 in an Italian CHD sample. It showed satisfactory invariance properties; GAD-7 is suitable for measuring anxiety in CHD while making significant comparisons of scores among stratified gender and age groups.
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Affiliation(s)
- Tatiana Bolgeo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
| | - Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy; Health Professions' Direction, Maggiore della Carità Hospital, Novara, Italy
| | - Maura Lusignani
- Department of Biomedical Science for Health, University of Milan, Milan, Italy; School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Barbara Bassola
- School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure, Department of Research and Innovation, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, (Italy)
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Lim HJ, Moon E, Kim K, Suh H, Park J, Kim DR, Park JH, Shin MJ, Lee YH. Cluster Analysis on the Mental Health States in a Community Sample of Young Women During Pre-Pregnancy, Pregnancy, or the Postpartum Period. Psychiatry Investig 2023; 20:445-451. [PMID: 37253470 DOI: 10.30773/pi.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/23/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE It is necessary to identify the mental health types of young women considering the importance of the mental health during the peripartum period. This study aimed to classify the mental health types in a community sample of young women with pre-pregnancy, pregnancy, or the postpartum period. METHODS A total of 293 young women during pre-pregnancy, pregnancy, or the postpartum period were included in this study. The clinical characteristics of depression, anxiety, perceived stress, and quality of life were assessed. The clinical characteristics of the subject were classified by cluster analysis and compared by analysis of variance. RESULTS From the cluster analysis, the subjects were classified into three groups. Cluster 1 showed significantly lower depression and anxiety and higher quality of life than those of cluster 2 and 3. Cluster 2 demonstrated significantly higher depression and anxiety and lower quality of life than those of cluster 3 and 1. Cluster 3 represented the intermediate levels between cluster 2 and 1. CONCLUSION This study suggested that young women during pre-pregnancy, pregnancy, or the postpartum period might be in a good mental health group, a high-risk group requiring active monitoring, or a group in need of treatment. By monitoring mental health, the groups with high risk or requiring treatment could be discovered and proper management for prevention or improvement of mental health and quality of life can be provided.
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Affiliation(s)
- Hyun Ju Lim
- Department of Psychology, Gyeongsang National University, Jinju, Republic of Korea
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Eunsoo Moon
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Kyungwon Kim
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hwagyu Suh
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jeonghyun Park
- Department of Psychiatry and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Du-Ri Kim
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung-Jun Shin
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
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Bautista J, Schueller SM. Understanding the Adoption and Use of Digital Mental Health Apps Among College Students: Secondary Analysis of a National Survey. JMIR Ment Health 2023; 10:e43942. [PMID: 36947115 PMCID: PMC10132041 DOI: 10.2196/43942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Increasing rates of mental health diagnoses in college students signal the need for new opportunities to support the mental health of this population. With many mental health apps being efficacious, they may be a promising resource for college campuses to provide support to their students. However, it is important to understand why (or why not) students might want to use apps and their desired features. OBJECTIVE Information on students' interest in mental health apps may inform which apps are to be provided and how campuses can support their use. This study aimed to understand the interest and hesitation in app use and the relationship between mental health needs, as defined by depression, anxiety, and positive mental health, and app use. METHODS The web-based Healthy Minds Study collected information on mental health needs, perceptions, and service use across colleges and universities. We used a sample of 989 participants who completed the survey between 2018 and 2020 and an elective module on digital mental health. We analyzed the elective module responses using a mixed methods approach, including both descriptive and inferential statistics, along with thematic coding for open text responses. RESULTS The Results from this study revealed that anxiety (b=-0.07; P<.001), but not depression (b=0.03; P=.12) and positive mental health (b=-0.02; P=.17), was a significant predictor of app adoption. Prominent qualitative findings indicated that the most desired app features included tips and advice, access to resources and information, and on-demand support that involves interaction throughout the day. The participants also suggested an overall desire for human interaction to be integrated into an app. As predicted, hesitancy was encountered, and the qualitative results suggested that there was a lack of interest in the adoption of mental health app and preference. CONCLUSIONS The findings from this study underscore that simply providing digital mental health apps as tools may be insufficient to support their use in college campuses. Although many students were open to using a mental health app, hesitation and uncertainty were common in the participant responses. Working with colleges and universities to increase digital literacy and provide resources that allow students to gauge when app use is appropriate may be helpful when implementing mental health apps as resources in college campuses.
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Affiliation(s)
- Justine Bautista
- School of Social Ecology, University of California, Irvine, Irvine, CA, United States
| | - Stephen M Schueller
- School of Social Ecology, University of California, Irvine, Irvine, CA, United States
- Department of Psychological Science, University of California, Irvine, Irvine, CA, United States
- Department of Informatics, University of California, Irvine, Irvine, CA, United States
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18
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Bista S, Lechner WV, Anderson M, Kenne KN, Kenne DR. Cigarette and e-cigarette use as a function of psychological distress following COVID-19 related university campus closures. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:239-248. [PMID: 36920934 DOI: 10.1080/00952990.2023.2171300] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background: Individuals experienced increased social isolation resulting from the COVID-19 pandemic. Studies have found social isolation and loneliness to be strongly associated with anxiety and depression, which have been associated with increased smoking and vaping rates among young adults, including college students.Objectives: To examine relationships between psychological distress and nicotine use within the context of the COVID-19 pandemic.Methods: A cross-sectional online survey (n = 4634; 77.9% female) was used to collect nicotine use and psychological measures from students enrolled at a large Midwestern university. Timeline follow-back data were collected from students reporting current cigarette or electronic cigarette (e-cigarette) use in the week before and immediately following the closure of campus due to the pandemic. Generalized estimating equations were used to examine the interaction between nicotine use and psychological symptoms across the 2-week period.Results: Both cigarette (Rate ratio (RR) = 1.115, 95% CI = 1.061, 1.171, p < .0001) and e-cigarette (β = 0.258, 95% CI = 0.166, 0.351, p < .0001) use increased significantly following campus closure. Students experiencing higher levels of depression reported greater increases in e-cigarette use frequency over time as compared to students reporting fewer symptoms of depression (β = 0.018, 95% CI = 0.006, 0.030, p = .004).Conclusions: Increases in nicotine use were found immediately following the implementation of public health safety measures that closed most university campuses. Additional and/or increased stressors have potentially impacted young adults who are college students as a result of campus closures resulting from the pandemic, which may have contributed to further increases in nicotine use.
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Affiliation(s)
- Saroj Bista
- College of Public Health, Kent State University, Kent, OH, USA
| | - William V Lechner
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Megan Anderson
- College of Public Health, Kent State University, Kent, OH, USA
| | - Kaylie N Kenne
- College of Public Health, Kent State University, Kent, OH, USA
| | - Deric R Kenne
- College of Public Health, Kent State University, Kent, OH, USA
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Ramos MS, Corona R, Dempster KW, Morton SCM, Everhart RS. The COVID-19 pandemic: asthma control, tobacco use, and mental health among African American and Latinx college students. J Asthma 2023; 60:496-507. [PMID: 35385676 DOI: 10.1080/02770903.2022.2062673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study investigated the impact of COVID-19 on tobacco use and mental health in US African American and Latinx college students with asthma. Associations among asthma control, tobacco use, and mental health were also examined. METHODS 105 African American and Latinx college students with asthma (18-23 years) completed two online questionnaires (June 2019-March 2020 for Time 1; August 2020-October 2020 for Time 2). Participants completed the Epidemic-Pandemic Impacts Inventory (measure of COVID-19 impact), Asthma Control Test, Generalized Anxiety Disorder scale, Patient Health Questionnaire (measure of depression), Perceived Stress Scale, and items related to tobacco use. RESULTS Asthma control improved (t = -3.326, p = 0.001) from Time 1 to 2, and e-vapor product use decreased (χ2104 = 6.572, p = 0.010). COVID-19 impact was positively associated with students' symptoms of anxiety, depression, and perceived stress (B = 0.201, p < 0.001; B = 0.179, p < 0.001; and B = 0.199, p = 0.001, respectively) at Time 2. These results remained significant with the Benjamini-Hochberg correction. Asthma control at Time 1 was negatively associated with anxiety symptoms at Time 2 (B = -0.418, p = 0.023); however, associations with perceived stress (B = -0.514, p = 0.019) and all other tobacco product use (B = -0.233, p = 0.030) did not remain significant with the Benjamini-Hochberg correction. CONCLUSIONS As hypothesized, a higher COVID-19 impact score was associated with students endorsing more mental health symptoms. Better control of asthma symptoms before the pandemic predicted fewer anxiety symptoms during the pandemic.
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20
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Post AA, Dailey DL, Bayman EO, Chimenti RL, Costigan M, Franck C, Huff T, Johnson E, Koepp M, Lafontant DE, McCabe ME, Neill-Hudson T, Vance CGT, Van Gorp B, Zimmerman BM, Ecklund D, Crofford LJ, Sluka KA. The Fibromyalgia Transcutaneous Electrical Nerve Stimulation in Physical Therapy Study Protocol: A Multisite Embedded Pragmatic Trial. Phys Ther 2022; 102:pzac116. [PMID: 36036838 PMCID: PMC10071449 DOI: 10.1093/ptj/pzac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 06/01/2022] [Accepted: 08/01/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention that provides an electrical current through the skin to produce analgesia. The primary purpose of this study is to examine if the addition of TENS to routine physical therapy improves movement-evoked pain in individuals with fibromyalgia in a physical therapy clinical setting. METHODS Fibromyalgia TENS in Physical Therapy Study is a phase III embedded pragmatic clinical trial funded through the National Institutes of Health Helping to End Addiction Long-Term Initiative. This trial will utilize a randomized cluster design that includes more than 110 physical therapists in 24 to 30 physical therapy clinics within 6 health care systems and 7 states. Clinics will be randomized to TENS or No-TENS, stratified by health care system and clinic size. The plan is to enroll 600 participants, with all participants completing physical therapy as prescribed by their physical therapist. Participants at TENS clinics will utilize TENS for a minimum of 2-hour per day while at the physical therapy clinic and at home when active. The primary outcome is reduction in movement-evoked pain from baseline to day 60 on an 11-point numeric rating scale when participants sit and stand 5 times (Sit and Stand Test). Secondary outcomes include resting pain and fatigue, pain interference, fibromyalgia disease activity, movement-evoked fatigue, multidimensional assessment of fatigue, rapid assessment of physical activity, patient global impression of change, and common data elements shared across studies supported through the Helping to End Addiction Long-Term Initiative. IMPACT The findings from this study will provide effectiveness data on TENS for individuals with fibromyalgia for health care policymakers, clinicians, and insurers. Data from this study will also inform future pragmatic trials for nonpharmacological interventions and chronic musculoskeletal pain conditions.
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Affiliation(s)
- Andrew A Post
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Dana L Dailey
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
- Physical Therapy Department, St. Ambrose University, Davenport, Iowa, USA
| | - Emine O Bayman
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
- Department of Biostatistics, The University of Iowa, Iowa City, Iowa, USA
- Department of Anesthesia, The University of Iowa, Iowa City, Iowa, USA
| | - Ruth L Chimenti
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Michele Costigan
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - Carla Franck
- Kepros Physical Therapy, Cedar Rapids, Iowa, USA
| | - Trevis Huff
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - Elizabeth Johnson
- Vanderbilt University Medical Center, Division of Rheumatology and Immunology, Nashville, Tennessee, USA
| | - Maxine Koepp
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - David-Erick Lafontant
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
- Department of Biostatistics, The University of Iowa, Iowa City, Iowa, USA
| | - Megan E McCabe
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
- Department of Biostatistics, The University of Iowa, Iowa City, Iowa, USA
| | - Tina Neill-Hudson
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - Carol G T Vance
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Barb Van Gorp
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Bridget M Zimmerman
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - Dixie Ecklund
- The University of Iowa Clinical Trials Statistical and Data Management Center, Iowa City Iowa, USA
| | - Leslie J Crofford
- Vanderbilt University Medical Center, Division of Rheumatology and Immunology, Nashville, Tennessee, USA
| | - Kathleen A Sluka
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
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Martínez-Vázquez S, Martínez-Galiano JM, Peinado-Molina RA, Gutiérrez-Sánchez B, Hernández-Martínez A. Validation of General Anxiety Disorder (GAD-7) questionnaire in Spanish nursing students. PeerJ 2022; 10:e14296. [PMID: 36340193 PMCID: PMC9635356 DOI: 10.7717/peerj.14296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/03/2022] [Indexed: 11/07/2022] Open
Abstract
Background Nursing students are at risk of anxiety during their university education. Objective To determine the psychometric characteristics of the General Anxiety Disorder (GAD-7) questionnaire in a population of university nursing students. Methods A cross-sectional study was carried out with 170 students at the University of Jaen (Spain) in 2022. An online questionnaire was administered that included sociodemographic and student profile variables, the GAD-7 questionnaire, and the Goldberg anxiety subscale. An exploratory factor analysis (EFA), validation with convergence, and reliability analysis using Cronbach's α were performed. Results The EFA identified a single component that explained 63.50% of the variance. It was positively correlated with the Goldberg anxiety subscale (r = 0.653; p < 0.001). A statistically significant association was observed with academic year, gender, and having experienced an anxiety crisis (p < 0.005). Internal consistency with Cronbach's α was 0.903. Conclusion The GAD-7 presents appropriate psychometric characteristics for use in a university population of nursing students. It is capable of detecting symptoms and generalized anxiety disorder, making it a useful and simple tool for detecting anxiety-related problems in this population.
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22
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Nguyen B, Ivanov M, Bhat V, Krishnan S. Digital phenotyping for classification of anxiety severity during COVID-19. Front Digit Health 2022; 4:877762. [PMID: 36310921 PMCID: PMC9612961 DOI: 10.3389/fdgth.2022.877762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022] Open
Abstract
COVID-19 has led to an increase in anxiety among Canadians. Canadian Perspectives Survey Series (CPSS) is a dataset created by Statistics Canada to monitor the effects of COVID-19 among Canadians. Survey data were collected to evaluate health and health-related behaviours. This work evaluates CPSS2 and CPSS4, which were collected in May and July of 2020, respectively. The survey data consist of up to 102 questions. This work proposes the use of the survey data characteristics to identify the level of anxiety within the Canadian population during the first- and second-phases of COVID-19 and is validated by using the General Anxiety Disorder (GAD)-7 questionnaire. Minimum redundancy maximum relevance (mRMR) is applied to select the top features to represent user anxiety, and support vector machine (SVM) is used to classify the separation of anxiety severity. We employ SVM for binary classification with 10-fold cross validation to separate the labels of Minimal and Severe anxiety to achieve an overall accuracy of 94.77 ± 0.13 % and 97.35 ± 0.11 % for CPSS2 and CPSS4, respectively. After analysis, we compared the results of the first and second phases of COVID-19 and determined a subset of the features that could be represented as pseudo passive (PP) data. The accurate classification provides a proxy on the potential onsets of anxiety to provide tailored interventions. Future works can augment the proposed PP data for carrying out a more detailed digital phenotyping.
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Affiliation(s)
- Binh Nguyen
- Signal Analysis Research (SAR) Group, Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Martin Ivanov
- Signal Analysis Research (SAR) Group, Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
| | - Venkat Bhat
- Signal Analysis Research (SAR) Group, Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
- Interventional Psychiatry Program, St. Michael’s Hospital, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sri Krishnan
- Signal Analysis Research (SAR) Group, Department of Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, ON, Canada
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Kong L, Cui Y, Gong Q. Duration of Keeping an Exercise Habit and Mental Illness and Life Attitude among University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811669. [PMID: 36141940 PMCID: PMC9517129 DOI: 10.3390/ijerph191811669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 05/12/2023]
Abstract
Physical exercise has beneficial effects on human health, and several studies have examined the association between exercise and mental health. However, most of these studies focused on exercise intensity, duration, or frequency. Evidence for the association between the duration of maintaining an exercise habit and mental illness is lacking, especially in young adulthood-a crucial period that bridges adolescence and adulthood. This study investigated the association between the duration of keeping an exercise habit and mental illness and life attitude among Chinese university students. A total of 11,392 university students participated in this study (6866 men and 4526 women). The duration of keeping an exercise habit was evaluated using a questionnaire with relevant questions. Exercise habit was defined as exercising for longer than 30 min per session and more than twice a week. Mental illness consisted of two elements: depressive symptoms-assessed using the Zung Self-rating Depression Scale, and anxiety symptoms-assessed using the seven-item Generalized Anxiety Disorder scale. Life attitude was assessed using a questionnaire with relevant questions. Multivariate logistic regression analysis examined the adjusted association between the duration of keeping an exercise habit and mental illness and life attitude. In the final adjusted model, compared to the no exercise category, the odds ratios and 95% confidence intervals (CIs) of depressive symptoms were 0.80 (0.70, 0.91) for those with an exercise habit of 1-4 months, and 0.72 (0.63, 0.83) for those with one of >4 months (p for trend <0.001). Additionally, when compared to participants with no exercise habit, the adjusted odds ratios (95% CIs) for anxiety symptoms were 1.01 (0.90, 1.14) for those with a habit of 1-4 months and 0.78 (0.69, 0.88) for those with one of >4 months (p for trend =0.001). A longer duration of keeping an exercise habit was also significantly associated with positive life attitudes. Our results showed that a long duration of keeping an exercise habit was significantly associated with a lower prevalence of mental illness among university students. Further, maintaining a more prolonged exercise habit may benefit individuals' mental health in young adulthood.
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Affiliation(s)
- Lingfeng Kong
- Department of Physical Education, Hohai University, 1 Xikang Road, Nanjing 210098, China
| | - Yufei Cui
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Qiang Gong
- Department of Physical Education, Huaiyin Institute of Technology, Huaian 223003, China
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Gavurova B, Ivankova V, Rigelsky M, Mudarri T. Internet Addiction in Socio-Demographic, Academic, and Psychological Profile of College Students During the COVID-19 Pandemic in the Czech Republic and Slovakia. Front Public Health 2022; 10:944085. [PMID: 35812472 PMCID: PMC9260220 DOI: 10.3389/fpubh.2022.944085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 05/31/2022] [Indexed: 12/03/2022] Open
Abstract
Internet addiction is a serious problem among young adults that requires increased attention, especially at a time of distance learning during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to assess the relationships between internet addiction and selected socio-demographic, study-related, and psychological characteristics of college students. Internet addiction was measured using the Internet Addiction Test both overall and in its individual subscales (Salience, Excessive Use, Neglect Work, Anticipation, Lack of Control, and Neglect Social Life). The selected characteristics represented (1) socio-demographic profile (gender, age, residence, family), (2) academic profile (housing during the semester, form of study), and (3) psychological profile (depressive symptoms—the Patient Health Questionnaire, stress—the Perceived Stress Scale, anxiety symptoms—the Generalized Anxiety Disorder). Data collection took place during the first wave of the COVID-19 pandemic in 2020 at Czech and Slovak colleges, with 1,422 students from the Czech Republic and 1,677 students from Slovakia participating in the research. The analytical processes were carried out through descriptive analysis, non-parametric difference analysis, and multiple negative binomial regression. Mild internet addiction was found in 387 (27.2%) Czech and 452 (27.0%) Slovak students. Moderate internet addiction was identified in 49 (3.4%) students from the Czech Republic and in 100 (6.0%) students from Slovakia. Two (0.1%) Czech and three (0.2%) Slovak students reported severe internet addiction. Increased likelihood of internet addiction overall, as well as in most individual subscales, was found particularly among male students and students who lived away from home during the semester. Depressive symptoms and stress could also be considered significant predictors in both countries. These results are important for the development of effective strategies and prevention programs, as Internet addiction may be a serious problem in the future, given the current times. When assessing internet addiction among college students, it would also be appropriate to evaluate the individual internet addiction subscales and their specifics.
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Affiliation(s)
- Beata Gavurova
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia
- *Correspondence: Beata Gavurova
| | - Viera Ivankova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Martin Rigelsky
- Department of Marketing and International Trade, Faculty of Management and Business, University of Prešov, Prešov, Slovakia
| | - Tawfik Mudarri
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
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Gerdes ME, Aistis LA, Sachs NA, Williams M, Roberts JD, Rosenberg Goldstein RE. Reducing Anxiety with Nature and Gardening (RANG): Evaluating the Impacts of Gardening and Outdoor Activities on Anxiety among U.S. Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5121. [PMID: 35564513 PMCID: PMC9100102 DOI: 10.3390/ijerph19095121] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic impacted mental health. Growing research has identified the mental health benefits of nature contact, including gardening. We used a cross-sectional survey to investigate the association between gardening and other outdoor activities with anxiety among U.S. adults. The RANG (Reducing Anxiety with Nature and Gardening) survey was distributed online from June−September 2020 through social media (Twitter and Facebook) and a national Master Gardeners listserv. Survey questions captured demographics, COVID-19 experiences, gardening, outdoor activities, and anxiety using the Generalized Anxiety Disorder 7-item scale. Data were analyzed using chi-square, Fisher’s exact, and Kruskal−Wallis tests, as well as logistic regression. Among participants, 46% reported anxiety symptoms. Participants who had gardened ≥ 15 years and those gardening > 8 h over two weeks had lower anxiety scores. Spending more time outdoors on weekdays also decreased anxiety scores. After adjusting for covariates, lower odds of anxiety were identified for 50−69 and 70−89-year-olds vs. 18−29-year-olds; males vs. females; and Texas vs. Maryland residents. These findings confirm increased anxiety during the COVID-19 pandemic and suggest that sustained gardening and other outdoor activities could help reduce anxiety.
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Affiliation(s)
- Megan E. Gerdes
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Lucy A. Aistis
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Naomi A. Sachs
- Department of Plant Science and Landscape Architecture, University of Maryland, College Park, MD 20742, USA;
| | - Marcus Williams
- Baltimore City Extension, University of Maryland Extension, Baltimore, MD 21215, USA;
| | - Jennifer D. Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Rachel E. Rosenberg Goldstein
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
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Maker Castro E, Dull B, Hoyt LT, Cohen AK. Associations between critical consciousness and well-being in a national sample of college students during the COVID-19 pandemic. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:760-777. [PMID: 34352131 PMCID: PMC8426919 DOI: 10.1002/jcop.22678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/05/2021] [Accepted: 07/16/2021] [Indexed: 05/06/2023]
Abstract
Critical consciousness (CC) may promote well-being, particularly during the COVID-19 pandemic. In a national survey of 707 college students conducted in April 2020, we first validated the Short Critical Consciousness Scale (ShoCCS) among youth groups not often specifically examined in CC measurement (i.e., Asian, immigrant-origin, LGBQ+, and women youth). Next, we examined associations between ShoCCS subscales and validated measures of both anxiety (Generalized Anxiety Disorder-7) and hopefulness (The Individual-Differences Measure in Hopefulness). The ShoCCS achieved measurement invariance across racial/ethnic groups and immigrant-origin status, and partial invariance among LGBQ+ and women-identifying youth. We found critical reflection and action associated with anxiety for the full sample, but no evidence of moderation by sociodemographic factors. ShoCCS subscales were differentially associated with hopefulness for Asian youth and LGBQ+ youth. This study contributes to the evolution of CC measurement and extends the field by identifying well-being associations during the onset of the COVID-19 pandemic.
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Affiliation(s)
- Elena Maker Castro
- Division of Human Development and Psychology, Graduate School of Education and Information SciencesUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Brandon Dull
- Department of PsychologyFordham UniversityNew York CityNew YorkUSA
| | - Lindsay T. Hoyt
- Department of PsychologyFordham UniversityNew York CityNew YorkUSA
| | - Alison K. Cohen
- Department of Epidemiology and Biostatistics, School of MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Screening for generalized anxiety disorder (GAD) and associated factors in adolescents and young adults with type 1 diabetes: Cross-sectional results of a Germany-wide population-based study. Diabetes Res Clin Pract 2022; 184:109197. [PMID: 35065100 DOI: 10.1016/j.diabres.2022.109197] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/29/2021] [Accepted: 01/13/2022] [Indexed: 01/09/2023]
Abstract
AIMS The aims of this study were to screen 14- to 30-year-olds with early-onset type 1 diabetes for generalized anxiety disorder (GAD) and to compare the characteristics of the study participants who had a positive result for GAD with those who had a negative result. METHODS This study used data from a questionnaire survey conducted from 2018 to 2019. The GAD-7 questionnaire was used to screen for GAD (positive: GAD-7 score ≥ 10). All regression analyses were adjusted for age, sex, depression diagnosis and considered multiple testing. RESULTS The 713 participants had a mean GAD-7 score of 4.32 (SD 4.18). A total of 12% of the study population (10% of adolescents, 13% of adults) was screened positive for GAD. Positive screening results were associated with impairments in various domains, such as self-assessed physical performance (RR poor versus good 3.03 [95% CI 1.85-4.96]), difficulty falling asleep (RR ≥3 times/week versus not during the last 4 weeks 5.36 [2.86-10.07]), glycemic control (RR HbA1c per 1% 1.16 [1.03-1.31]), and diabetes treatment satisfaction (RR poor versus good 2.67 [1.43-5.00]). CONCLUSIONS Diabetologists should be aware that adolescents and young adults with GAD symptoms might experience extensive impairments in their daily lives.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany; Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Germany; German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Food insecurity and mental health of college students in Lebanon: a cross-sectional study. J Nutr Sci 2022; 11:e68. [PMID: 36106091 PMCID: PMC9428660 DOI: 10.1017/jns.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
The present study aimed to assess the prevalence of food insecurity (FI) among college students and explore its association with indicators of mental and psychosocial health. Data were collected using a cross-sectional online survey from college students in different universities in Lebanon during the Spring 2021 semester. FI was assessed using the validated eight-item food insecurity experience scale. The mental health of college students was assessed using validated screening tools for depression, anxiety and well-being, namely the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder-7 (GAD-7) and the World Health Organization (WHO-5) index, respectively. Multiple linear regression models were conducted to assess the relationship of FI with PHQ-9, GAD-7 and WHO-5 scores. A total of 745 students completed the online survey. Approximately 39 % of students in the sample were experiencing FI of which 27·4, 8·1, and 3·5 % were experiencing mild, moderate and severe FI , respectively. Low maternal education, low household monthly income and high levels of stress were significant correlates of FI among college students (P-trend < 0·001). In addition, 22·6 and 34·4 % of students showed severe symptoms of depression and anxiety, respectively. Regression models showed that FI was associated with higher scores on PHQ-9 and GAD-7 (β = 2·45; 95 % CI [1·41, 3·49]) and (β = 1·4; 95 % CI [1·1, 2·2], respectively) and lower scores on WHO-5 (β = −4·84; 95 % CI [−8·2, −1·5]). In conclusion, a remarkable proportion of college students reported experiencing different forms of FI, which was associated with poorer mental health and well-being outcomes. Public health programmes and interventions are needed to mitigate FI and improve student health-related outcomes.
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Thai H, Davis CG, Stewart N, Gunnell KE, Goldfield GS. The Effects of Reducing Social Media Use on Body Esteem Among Transitional-Aged Youth. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2021. [DOI: 10.1521/jscp.2021.40.6.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction. Social media use (SMU) and body image concerns are highly prevalent in youth. Although several studies have shown that high SMU is crosssectionally associated with lower body esteem, experimental evidence is lacking. This pilot study experimentally evaluated the effects of reducing SMU on body esteem among transitional aged youth (TAY) with emotional distress. Methods. Thirty-eight undergraduate students presenting with elevated symptoms of anxiety/depression were randomly assigned to the intervention (n = 16), where SMU was restricted to 60 minutes/day, or to the control group (n = 22), where SMU was not restricted. SMU was monitored via screen-time trackers in participants’ smartphone submitted daily during baseline (1-week) and intervention (3-week) periods. Baseline and post-intervention measurements were taken to assess appearance and weight esteem as well as symptoms of anxiety and depression as secondary outcomes. Results. A significant group × time interaction emerged indicating that the intervention participants showed a significantly greater increase in appearance esteem over the 4 weeks compared to controls. There was no significant between-group difference on change in weight esteem. A significant group × time interaction emerge on anxiety indicating that intervention participants showed a significantly greater improvement in anxiety over the study period compared to controls. There was no significant between-group difference on change in depressive symptoms. Discussion. Reducing SMU may be a feasible and effective method of improving appearance esteem and reducing anxiety in a high-risk population of TAY with emotional distress; however, more high-quality randomized controlled trials are needed to confirm findings.
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Stapinski LA, Prior K, Newton NC, Biswas RK, Kelly E, Deady M, Lees B, Teesson M, Baillie AJ. Are we making Inroads? A randomized controlled trial of a psychologist-supported, web-based, cognitive behavioral therapy intervention to reduce anxiety and hazardous alcohol use among emerging adults. EClinicalMedicine 2021; 39:101048. [PMID: 34622183 PMCID: PMC8478683 DOI: 10.1016/j.eclinm.2021.101048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Anxiety and alcohol use disorders are common and disabling conditions that people typically endure for many years before accessing treatment. The link between anxiety and alcohol use is well-established, with these issues commonly emerging and/or escalating during emerging adulthood. This randomized controlled trial evaluated a psychologist-supported, web-based intervention, designed with and for emerging adults, that aims to promote adaptive coping strategies, and prevent anxiety and alcohol use from progressing to chronic, mutually-reinforcing disorders. METHODS Between December 2017 and September 2018, 123 emerging adults (aged 17-24) reporting anxiety symptoms and hazardous alcohol use were randomized to receive the Inroads or control (assessment plus alcohol information) intervention. The Inroads program combined five web-based cognitive behavioral therapy modules with weekly psychologist support via email/phone. Primary outcomes were alcohol consumption, severity of alcohol-related consequences, and general anxiety symptoms, assessed at baseline, 2 and 6-months post-baseline. Secondary outcomes included hazardous alcohol use and social anxiety. Trial Registration: Prospectively registered in the Australian New Zealand Clinical Trials Registry, ACTRN12617001609347. FINDINGS Alcohol consumption and associated consequences reduced in both groups, with the Inroads group reporting greater alcohol reductions by 6-month follow-up (mean difference -0.74, 95% CI: -1.47 to -0.01, d = 0.24). Relative to controls, hazardous alcohol use reduced among Inroads participants at both follow-ups (2-month mean difference -2.14, 95% CI: -4.06 to -0.22). Inroads participants also reported reduced symptoms of general (mean difference -3.06, 95% CI: -4.97 to -1.15, d = 0.88) and social anxiety (mean difference -3.21, 95% CI: -6.34 to -0.07, d = 0.32) at 2-month follow-up, with improvements in social anxiety sustained at 6-months. INTERPRETATION The Inroads program demonstrated beneficial effects on alcohol consumption, hazardous alcohol use, and anxiety symptoms. The web-based format is aligned with youth treatment preferences and can be delivered at scale to achieve wide dissemination and reduce the significant burden associated with these chronic, mutually reinforcing conditions. FUNDING Australian Rotary Health, Australian National Health and Medical Research Council.
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Affiliation(s)
- Lexine A. Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Corresponding author.
| | - Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Nicola C. Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Raaj Kishore Biswas
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
- Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney 2052, Australia
| | - Erin Kelly
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney 2052, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Sydney Medical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Andrew J. Baillie
- Sydney School of Health Sciences, University of Sydney, Sydney 2006, Australia
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Predictors of Anxiety in the COVID-19 Pandemic from a Global Perspective: Data from 23 Countries. SUSTAINABILITY 2021. [DOI: 10.3390/su13074017] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Prior and ongoing COVID-19 pandemic restrictions have resulted in substantial changes to everyday life. The pandemic and measures of its control affect mental health negatively. Self-reported data from 15,375 participants from 23 countries were collected from May to August 2020 during the early phases of the COVID-19 pandemic. Two questionnaires measuring anxiety level were used in this study—the Generalized Anxiety Disorder Scale (GAD-7), and the State Anxiety Inventory (SAI). The associations between a set of social indicators on anxiety during COVID-19 (e.g., sex, age, country, live alone) were tested as well. Self-reported anxiety during the first wave of the COVID-19 pandemic varied across countries, with the maximum levels reported for Brazil, Canada, Italy, Iraq and the USA. Sex differences of anxiety levels during COVID-19 were also examined, and results showed women reported higher levels of anxiety compared to men. Overall, our results demonstrated that the self-reported symptoms of anxiety were higher compared to those reported in general before pandemic. We conclude that such cultural dimensions as individualism/collectivism, power distance and looseness/tightness may function as protective adaptive mechanisms against the development of anxiety disorders in a pandemic situation.
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Byrd-Bredbenner C, Eck K, Quick V. GAD-7, GAD-2, and GAD-mini: Psychometric properties and norms of university students in the United States. Gen Hosp Psychiatry 2021; 69:61-66. [PMID: 33571925 DOI: 10.1016/j.genhosppsych.2021.01.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/31/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Generalized Anxiety Disorder (GAD-7 & GAD-2) scales are reliable and valid instruments for assessing generalized anxiety symptoms in the general and clinical populations. However, little attention has been given to the psychometric qualities of GAD-7 and reduced length versions in a diverse sample of young adult college students stratified by sex. Thus, the aims for this study are to test psychometric properties and normative values of GAD-7, GAD-2, and GAD-Mini scales. METHOD U.S university students (N = 4128; females n = 2527, males n = 1601) ages 18-26 years completed an online survey composed of the GAD-7, Patient Health Questionnaire (PHQ-2), and demographic questions. RESULTS Exploratory principal components analysis yielded a one factor solution for GAD-7 across sexes. In reducing scale length, iterative confirmatory principal components analyses stratified by sex revealed a two-item scale (GAD-Mini) with high factor loading items, internal consistency (α ≥ 0.85), and construct validity with PHQ-2 (r ≥ 0.55). Normative data indicate that regardless of whether GAD-7, GAD-2, or GAD-Mini scores were considered, about three-quarters of men and two-thirds of women scored below the reasonable cut-points in screening for GAD. CONCLUSION Findings from this study may help health care providers and researchers better understand the interpretation of these scales among university students when screening for GAD.
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Affiliation(s)
- Carol Byrd-Bredbenner
- Department of Nutritional Sciences, School of Environmental & Biological Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, USA
| | - Kaitlyn Eck
- Department of Nutritional Sciences, School of Environmental & Biological Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, USA
| | - Virginia Quick
- Department of Nutritional Sciences, School of Environmental & Biological Sciences, Rutgers University, 26 Nichol Avenue, New Brunswick, NJ, USA.
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"Constant Stress Has Become the New Normal": Stress and Anxiety Inequalities Among U.S. College Students in the Time of COVID-19. J Adolesc Health 2021; 68:270-276. [PMID: 33288459 DOI: 10.1016/j.jadohealth.2020.10.030] [Citation(s) in RCA: 129] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/23/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this study is to document young adults' perceived stress and anxiety in a diverse sample of college students across the U.S. during the COVID-19 pandemic. METHODS We recruited, via Instagram, a sample of full-time college students aged 18-22 from across the U.S. We surveyed them in April (baseline; N = 707; mean age = 20.0, SD = 1.3) and July (follow-up) 2020. This study presents overall levels of perceived stress and general anxiety symptoms and inequalities across each of these outcomes by gender, sexual orientation, race/ethnicity, and household income. We also explore potential explanations for these health issues by analyzing baseline qualitative data. RESULTS All students, on average, were suffering from perceived stress and anxiety, with especially high levels in April. We also identified inequalities in college student mental well-being, particularly by gender identity and sexual orientation. Women reported worse well-being compared with men; transgender and gender diverse and sexual minority youths reported worse outcomes than their cisgender, heterosexual peers at both time points. Qualitative data illustrate how the COVID-19 pandemic has generated educational, economic, and environmental stressors that are affecting college students' well-being. CONCLUSIONS As colleges and universities think about how to manage and mitigate the infectious disease dimensions of COVID-19 among their student populations, they must also consider who is most at risk for increased stress and anxiety during the pandemic.
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